Some Islamic Guidelines
By Dr. Abdullah M. Khouj*
We often hear people discussing depression and how it has become an associated symptom of our age, partly due to our extended life expectancy and its general challenges.
The purpose of this study is to explain the simple meaning of ordinary depression. Also explained are the psychological and psychiatric points of view and some of the Islamic guidelines on how to deal with ordinary depression.
Even though the word “depression” is widely used, it has different meanings to different individuals. The most commonly described is that depression is a feeling of distress, affliction, or grief within one’s self as a result of certain factors for which the individual may know the causes or sources, or may not, but experiences gloom and despair. The eventual outcome of these feelings is a general discomfort in most circumstances.
Depression often arises from a lack of securing one’s income, which often gives way to feelings of incompetence. Another cause may be rapid changes in our lives that we are unable to cope with. Oddly enough, even an increase in human population, creating a more competitive atmosphere, adds further provocation. These factors and many others can make us experience certain feelings and can cause emotional fluctuations with varied intensity.
Depression has become a primary main focus for psychiatrists and psychologists, who make a distinction between ordinary and abnormal depression.
Gotlib (1987) states that the term depression has a number of meanings; it covers a wide range of emotional states, ranging in severity from normal, everyday moods of sadness to psychotic episodes with increased risk of suicide.
Normal (ordinary) depression is apparent in the periods of sadness and disappointment we may suffer, in the forms of guilt, an increase in or loss of appetite, and/or an overall lack of energy. We may also experience these feelings in response to negative situations, e.g., the loss of a job, an argument with a friend, a poor mark on an exam, insecurity, poor communication with others, and the rise of problems for which the individual cannot find a solution, or of an inability to cope. Sometimes there is no apparent reason for these periods of sadness or disappointment; it seems as if it is just a feeling we have to go through. Sometimes the depressed person is aware of a problem, but feels powerless and lacks normal energy and assertiveness. In other cases, the depression may be quite pronounced and persistent, but the individual in question is still able to function reasonably well in everyday life. This is ordinary, simple neurotic depression. But since it is not disabling, it is not regarded as a mental illness.
Depression is particularly futile and self-defeating when it is based on a condition that one cannot possibly do anything about. An example is people who ‘worry’ about their age and actually seem to resent growing older. Depression can involve feelings of guilt where an individual is either consciously or subconsciously accepting blame for something that is not his fault. Perhaps, while a person is away on a business trip, his mother dies. He may reproach himself by saying (perhaps without expressing it openly), “Maybe if I hadn’t gone on this trip, she would have lived.” He knows this doesn’t make sense, but subconsciously accepts it and may develop a deep depression. The deeper the depression, the more likely he is to retreat from everyday life. If he does participate, it is half hearted, with few results. He will actually go out of his way to avoid activities he likes. The more extreme the depression, the more it becomes calculated self-punishment.
However, depression need not always be unhealthy or negative, but may be a sign of the awareness of an emotional problem which an individual can resolve. But chronic depression goes against the very grain of life and drains a person completely.
The symptoms of normal depression do not differ in kind from abnormal depression, but they do differ drastically in degree. Abnormal depression is comprised of one or more major depressive occurrences where there is a feeling of extreme elation or euphoria. These abnormal depressive occurrences may take weeks or months to appear, and can last for several months more. Those who experience this type of depression exhibit extreme changes in mood, motivation, thinking, and physical and motor functioning. The following characteristics are exhibited:
1.a depressed mood, complete despair, loneliness,
2.feeling of worthlessness and guilt- the individual sees himself without intelligence, attractiveness, health, or social skills;
3.reduced motivation, general interest and pleasure disappear from previously enjoyed activities;
4.disturbances of appetite, sleep, a person can neither eat nor sleep or eats and sleeps in excess;
5.psychomotor retardation or agitation, where people commonly become lethargic or become fidgety, pacing and moaning;
6.reduced energy- a person feels chronic exhaustion;
7.difficulties in thinking- retarded cognitive processes and difficulty in thinking, concentrating, or remembering; and recurrent thoughts of death or suicide, which do sometimes result in suicide. Psychiatrists thus diagnose depression as an illness that has biological causes and consider it a medical disorder (just like diabetes, high blood pressure, or heart disease). Day after day, these disorders affect the individual’s thoughts, feelings, physical health, and behavior.
WHAT ARE THE CAUSES OF DEPRESSION?
We have already seen the causes of ordinary depression. From a psychiatrist’s point-of-view, depression may be caused by many things, including:
Each discipline has its treatment and involves certain procedures, such as individual therapy, group therapy, medical treatment (the use of medicine); and in some cases, electroconvulsive therapy (ECT) and light therapy are useful.
It seems clear that in modern psychology there are several factors causing depression and the treatment lies in understanding these symptoms by the therapist and the patient, who together reach its source and try to find solutions. Treatment may take a long time.
The question arises whether it is possible to apply the same kind of treatment to all individuals. And does the individual have to go through therapy or psychiatric treatment? The answer is, no. Cause determines the treatment. Our problems primarily arise from our lack of understanding ourselves, our condition, and our function in life. We often set standard human rules to guide our lives.
For this reason, we fall short in understanding ourselves and our condition. We have to understand the Creator’s view of ourselves and the standard set for us as human beings. Understanding the purpose of our existence will help us eliminate many of our problems.
Islam teaches that this life is a life of test and trial. Each individual experiences many of these trials in the course of his or her life. Allah says in the Qur’an:
“Blessed be He in Whose Hand is the
Dominion, and He is Able to do all things.
Who has created death and life, that He may test you which of you is best in deed.And He is the All-Mighty, the Oft-Forgiving.” (67: 1-2)
In many Qur’anic verses, Allah speaks about the creation of the human being, his make-up, what helps him achieve psychological comfort, and what causes him to fall to his lowest levels of existence.
Allah also clarifies the factors that maintain good human qualities in feelings, emotions, and general health. As well, he explains what causes the deterioration of the human self and its psychological composition, and advises moderation in all matters, including happiness and sadness. He says:
“In order that you may not be sad over matters that you fail to get. Nor rejoice because of that which has been given to you. And Allah likes not prideful boasters.“(57:23)
In this verse, Allah makes the human being aware of his abilities, and makes him respond to things with wisdom and an open mind. This type of orientation makes the human being open, stable and balanced when facing life’s requirements and events. The human being becomes fearful and unsure if isolated from his surroundings, and deals with things as if they were events intended to cause him harm or to bring him down. But if he knows that life, its events, and the events that transpire by means of others are predetermined, then he reaches a level of understanding that makes him feel secure and comfortable. After reaching this level, he would neither feel sorrow for what has passed him by, nor would he feel excessively joyful. He will feel comfort for what Allah has determined. Allah also explains that a person has an appointed term in this life.
“If the appointed time fixed by Allah comes, it shall not be postponed, if only you knew.” (71:4)
He also says:
“There is a predetermined period for each nation, and if this period comes to them, they shall neither remain one hour later nor (shall they perish) one hour earlier.” (10:49)
Allah also explains that everything that befalls us is from Him:
No calamity befalls on the earth or in yourselves but is inscribed in the Book of Decrees (Al-Lauh Al-Mahfuz), before We bring it into existence. Verily, that is easy for Allah. (57:22)
Allah also explains that people are tested for their claim:
“Do people think that they will be left alone because they say: ‘We believe,’ and will not be tested? And we indeed tested those who were before them. And Allah will certainly make known (the truth of) those who are true, and will certainly make known (the falsehood of) those who are liars.” (29:2-5)
These verses show that Allah has to test his believing servants according to their degree of belief. From these verses and many others, Allah teaches people how to deal with depression before turning to other solutions, which is through self-realization and the recognition of the purpose of human existence. Our relationship with Allah should come before our dependence on ourselves or any human being. Our faith, our reliance, and trust in him, and our efforts to work and improve our situation are the keys to success and will help us face our problems and difficulties. This is the secret that causes the believer’s self-comfort from his troubles.
Iman (Faith) is the key to eliminate the unnecessary fear that we sometimes experience when we deal with people, because a person believes that whatever good or bad happens, it is through the will of Allah. Allah says:
“Those who said unto the people (i.e. believers): ‘Verily, the people (have gathered against you (a great army), therefore, fear them.‘ But it (only) increased them in faith, and they said: ‘Allah (Alone) is sufficient for us, and He is the Best Disposer of affairs (for us). So they returned with Grace and Bounty from Allah. No harm touched them; and they followed the good pleasure of Allah. And Allah is the Owner of Great Bounty. It is only Satan that suggests to you the fear of his supporters and friends, so fear them not, but fear Me, if you are (true) believers.“(3:173-175)
This shows that the true believer does not become weak or collapse when he faces trouble or hardship; rather he returns to Allah and refers all matters to Him and says: “For us Allah sufficeth, and He is the best Disposer of affairs and to Him we refer our matter.” Then, the condition of the believer will change from depression and despair to security and peace. Fear will be minimized and will be replaced with strength and the true will to face the cause of this fear and diminish it. Everything that causes human fear is within the power of Allah. And as long as what causes the fear is within the power of Allah, then when the believer says: For us Allah sufficeth, and He is the best Disposer of affairs, and is a true believer in Allah and is sure that ease will come to him from Allah, his fear will change to courage. He faces the cause of his fear and overcomes it. Abu Hurirah (may Allah be pleased with him) said: That the messenger of Allah when a matter unease him, raises his eye to the sky and says: “Praise be to the Almighty Allah,” and increases his efforts in supplication, “YA HAYYU YA QAYYUM” Oh You, the Living, Ever-watchful”.
In the sunan of Abi Daud, the prophet (pbuh) said to Abi Umamah, do you want me to teach you something, that if you say it, Allah the Almighty will take away your depression, and pay your debts? He said, yes. The prophet said: “Say when you wake up in the morning: 0 Allah, I seek refuge with you from depression and sadness, and I seek refuge with you from disability and laziness, and I seek refuge with you from cowardice and parsimony, and I seek refuge with you from the oppression of debt and the subjugation of men. He said: and I did. Allah the Almighty took away my depression and paid my debt.
Also it is mentioned in the sunan of Abi Daud that Abu Bakr (Radia’ lahu Anbu) said that the prophet (Pbuh) said: “The supplications of the distressed are Allahuma, your mercy I request, so don’t let me depend on myself in the twinkling of an eye, and reform my whole nature, there is no god but You.”
In Termizi the prophet (pbuh) also said: “I know a word that, when a person in difficulty says it, Allah will relieve him from that hardship. It is the word of my brother Younes.” The story of Younes is mentioned in the Qur’an for Muslims to deduce the value and importance of referring to Allah in every hardship and in all matters of our life. Allah says:
“And remember Zun-nun when he departed in wrath: He imagined that We had no power over him! But he cried through the depths of darkness, ‘There is no god but Thou: Glory to Thee: I was Indeed wrong!” So We listened to him: And delivered him from Distress: and thus do We deliver those who have faith.” (21:87)
When Younes left his people, angry with them because they did not believe in Allah, he was thinking that Allah had permitted him to leave. The whale swallowed him and he lived in darkness.
Then, he cried to his Lord with humility and sorrow, acknowledging that he had oppressed himself, because he did something that did not please Allah.
Allah the Almighty responded to his call and saved him from his distress and trouble. The prophet himself used this supplication and many others which can be used as divine medicine to treat certain psychological problems.
This type of preparation helps people face life’s requirements and events. It teaches that life is full of events that are either in their favor or the opposite. So, preparing the human being to recognize and face them will diminish the severity of the impact. If the individual is not well prepared, he will be extreme, either in happiness or sadness, and will not have the fortitude to face life’s events.
Allah teaches us that we should not live with an event for longer than its term. If the time of the event is finished, then our thoughts and feelings should not dwell on it.
Our prophet (pbuh) also teaches us that we should benefit from our experience in facing future events. He says: “The believer should not be bitten by the same terrier twice.”
Sometimes we feel depressed over certain events that we think are not good for us, only to find at the end that they may turn out to be in our favor. We make quick judgments and want matters to be resolved quickly. Allah says:
“Man is created of haste: I will show you My Ayat‘ (torment, proofs, evidences, verses, lessons, signs, revelations, etc.). So ask Me not to hasten (them).” (21:37)
Allah commands us not to be hasty in our decisions, but to be moderate and appreciative of what we have. Satisfaction and appreciation help the individual be comfortable and secure with himself. That does not mean the individual does not have to work and seek means of improving his condition. Allah the Almighty gives an example of what causes security and peace, and what causes the opposite. He says:
“And Allah puts forward the example of a township (Makkah), that dwelt secure and well content; its provision coming to it in abundance from every place, but it (its people) denied the favors of Allah (with ungratefulness). So Allah made it taste the extreme of hunger (famine) and fear; because of that which they used to do.” (16·112)
Allah shows that He substituted hunger for abundance and insecurity, and instability and anxiety for security. He also shows that what happened to them is because of their oppression of themselves, by being not grateful to the One who bestowed these gifts. Allah set this parable in the Qur’an to show that we, as humans, enjoy all the gifts that Allah has given; we did not create ourselves or our sustenance.
Being thankful and grateful to Him are some of the means that help us achieve security and comfort. Being thankful and grateful to Allah is based on the following steps: we have to acknowledge the gifts in our life with a pure heart, which are not because of our power, but because of the mercy of Allah and our gratitude.
“Verily, Korah was of Moses ‘people, but he behaved arrogantly towards them. And We gave him of the treasures, of which the keys would have been a burden to a body of strong men. When his people said to him: ‘Do not be glad (with ungratefulness to Allah‘s favors). Verily!‘ Allah likes not those who are glad (with ungratefulness to Allab‘s favors).
‘But seek, with that (wealth) which Allah has bestowed on you, the Home of the Hereafter, and forget not your portion of legal enjoyment in this world, and do good as Allah has been good to you, and seek not mischief in the land. Verily, Allah likes not the “Mufsidin” (those who commit great crimes and sins, oppressors, tyrants, mischief-makers, corruptors):
“He said: ‘This has been given to me only because of knowledge I possess.‘ Did he not know that Allah had destroyed, before him, generations of men who were stronger than him in might and greater in the amount (of riches) they had collected:’ (28:76-78 )
“0 Allah I ask you to place within me a self that is content with You, accepts your judgment and is satisfied with Your gifts and believes that we shall meet.”
Combined, these will help us deal with normal depression and prepare us to accept and deal with events as they happen. We will not be arrogant when we are at ease and will not become depressed or unhappy when certain matters take place. Also, we will not be deceived by the abundance of wealth or be weakened and impatient by its scarcity.
This is how Islam teaches people to deal with ordinary depression. For the physical causes of depression, Islam teaches us to seek the proper help, including medicine. Jaber Ibn Abdullah said that the prophet Mohammed (pbuh) said: “To each illness is a cure, if the medicine hit the illness, it will be cured with the will of Allah.” (Muslim)
Osamah Ibn Sharic said, I was sitting with the prophet (pbuh) and the Bedouins came, and said: o messenger of Allah! Do we treat ourselves? He
said, “Yes 0 servants of Allah treat yourselves, Allah the Almighty does not place an illness unless He places a cure.” (Ahmad)
Abu Khouzamah also said: “I said: ’0 messenger of Allah! Do you see the charms we use, a medicine with which we treat ourselves, and fearful things we
avoid, if they prevent anything of the will of Allah?’
The prophet (pbuh) said: ‘It is of the will of Allah.’ (Ahmad)
These sayings of the prophet show that there are causes and effects and the recommendations to seek treatment. When the prophet says, “For every illness there is a cure,” it encourages people to find the proper treatment for a specific illness.
If people don’t know about the treatment, it does not mean it does not exist. Rather it means that people did not search far enough to find it. This statement gives hope to those who are ill, to search for treatment, and to leave the matter with Allah. If people hope in Allah and search for treatment, it will strengthen their will and help them feel better.
An indication of a sound human mind is that the individual has an understanding of the purpose of his existence and thus, has a plan. A plan that helps him utilizes his time and gives him value to his existence. Allah in the Qur’an emphasizes the importance of using our mind to benefit from all things given to us. Meanwhile, He directs our attention to make use of all possible means. At the time we cannot neglect the contribution of the current theories in counseling, psychotherapy and psychiatry, in the field of human services. But we should screen them and make use of what is acceptable to us as Muslims. A point of difference is that many of the current theories study human behavior as a matter relating only to the present existence. Muslims believe that life is a field in which they plant their fruit for the next life. Islam helps determine the type of life the individual lives to achieve happiness. For those overcoming difficulties, we have to include understanding their social life, including their religious values.
It is important for us, if we want to deal with normal depression, to understand the Creator’s view of human nature, what benefits it and what makes it function. We should also transfer this view to our youth, through verbal teachings, actions, and reinforcement. If children observe their parents being content, while working to improve their lives, they will become open to dealing with reality and will have a balanced outlook. The key, then, to deal with our problems, is self-understanding. We reach self-understanding through relating to Allah our Creator and following his guidance. He said:
“But if they had done what they were (actually) told, it would have been best for them, and would have gone farthest to strengthen their (faith); and We should then have given them from Our presence a great reward; and We should have shown them the straightway. ” (4:66-68)
If parents and members of the family notice certain symptoms of the above-mentioned abnormal depression for more than two weeks, they should take the person to their health care provider for diagnosis.
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 This paper was published in 1997 in Al-Nur, The Isalmic Center Quarterly.